Exercise, weight loss and topical NSAIDs have the strongest evidence for knee arthritis pain. Cortisone gives short-term relief. PRP and stem cell injections show promise in some trials but evidence is still uncertain. This table summarises guideline positions from NICE (UK, 2022), AAOS (US, 2021) and OARSI (2019).
| Treatment | Evidence | Guideline position | Typical relief |
|---|---|---|---|
| Strengthening exercise | Strong | Recommended by all | Long term, while continued |
| Weight loss (if overweight) | Strong | Recommended by all | Long term |
| Topical NSAID gel | Strong | NICE first-line medicine | While used |
| Oral NSAIDs | Moderate | Short courses | While used |
| Paracetamol | Weak | NICE: not routinely | Small |
| Glucosamine / chondroitin | Weak | NICE: not recommended | Little or none |
| Brace (unloader) | Moderate | Option for some | While worn |
| Cortisone injection | Moderate (short term) | NICE: short-term option | Weeks to months |
| Hyaluronic acid injection | Weak / mixed | NICE: not recommended | Variable |
| PRP injection | Mixed | AAOS: limited evidence option | Some trials: 6 to 12 months |
| Stem cell injection | Early | Not in guidelines; research | Small trials: 12 months+ |
| Arthroscopic washout | Strong evidence of no benefit | Not recommended | None lasting |
| Knee replacement | Strong (severe OA) | For severe, failed non-surgical care | Many years |
Sources are listed on our sources page. Reviewed by Dr James Bristol, MD, PhD.